Circulating soluble CXCR4 levels did not differ between PA subtypes and controls, showing poor discrimination (AUC 0.52) for APA versus IHA diagnosis.
Does serum sCXCR4 measurement differentiate subtypes of primary aldosteronism (APA vs IHA) and correlate with adrenal CXCR4 expression on PET/MR?
Circulating sCXCR4 is not a useful biomarker for subtyping primary aldosteronism or reflecting adrenal CXCR4 expression.
Abstract Accurate subtyping of primary aldosteronism (PA) is essential for treatment selection. This study examined whether soluble CXC chemokine receptor type 4 (sCXCR4) in peripheral blood reflects adrenal CXCR4 expression assessed by 68Ga-pentixafor PET/MR, and whether sCXCR4 aids PA classification. A total of 160 subjects were enrolled, including 88 patients with PA (52 aldosterone-producing adenoma APA, 36 idiopathic hyperaldosteronism IHA) and 72 healthy volunteers. Serum sCXCR4 was measured by enzyme-linked immunosorbent assay. Group comparisons, correlation analyses, and receiver operating characteristic curves were used to evaluate diagnostic performance. Serum sCXCR4 did not differ significantly among APA, IHA, and controls, and showed no correlation with adrenal SUVₘax on PET/MR. The discriminatory value for distinguishing APA from IHA was poor (AUC 0. 52; 95% CI 0. 40–0. 64). These results suggest that circulating sCXCR4 does not mirror adrenal CXCR4 expression and has no diagnostic role in PA subtyping.
Chao et al. (2026) studied this question. Circulating soluble CXCR4 levels did not differ between PA subtypes and controls, showing poor discrimination (AUC 0.52) for APA versus IHA diagnosis.
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